Eur Arch Otorhinolaryngol (2007) 264:1013–1018 DOI 10.1007/s00405-007-0310-4 123 RHINOLOGY The sensitivity of nasal eosinophilia in allergic rhinitis Murat Cem Miman · Onder Uzun · Iclal Gurses · Irfan Kuku · Orhan Ozturan · Mustafa Akarcay Received: 8 February 2007 / Accepted: 23 March 2007 / Published online: 28 April 2007 © Springer-Verlag 2007 Abstract Evaluation of nasal epithelial samples is a part of clinical allergy practice. The aim of this study is to reveal the sensitivity of the nasal eosinophilia using Rhino-probe and Wright-Giemsa staining by means of all available nasal eosinophilia scoring systems. In 30 patients (12 males, 18 females; mean age = 31.6 years) with clinical diagnosis of allergic rhinitis, both sides of the nose were sampled. The content of the cupped tip of the probe has been prepared and stained for nasal cytological examination under oil immer- sion by light microscopy. Nasal eosinophilia has been assessed by scoring systems. The sensitivity of nasal eosino- philia has been revealed. The nasal eosinophilia scores have been compared between nasal sides (right or left nose) and also between the examiners’ observations for the same sam- ple. Sensitivity values of nasal eosinophilia according to previously described criteria in the literature have been found to be between 13.33 and 80%. As the agreements for the nasal eosinophilia diagnosis between the sides of the nasal cavity and between the blinded examiners, the criteria of nasal eosinophilia such as the ratio of eosinophils to neutrophils or to all inXammatory cells rendered diVerent diagnoses between the examiners (P < 0.01). The results of nasal cavity sides and Meltzer-scoring yielded no diVer- ences (P > 0.05). The substantial intraindividual variations when comparing the results obtained from the nasal sides and low sensitivity reveal that the nasal cytology needs more objective and standardized methods for a better diVerential diagnosis of chronic rhinitis. Keywords Allergy · Rhinitis · Eosinophilia · Cytology Introduction DeWnitive therapeutic approach for chronic rhinitis patients could be developed if the diVerential diagnosis is undoubt- edly performed by the relevant laboratory studies. Cur- rently, a thorough history, anterior rhinoscopy, nasal endoscopy, skin prick test, spesiWc IgE analysis, rhinoma- nometry, acoustic rhinometry, nasal provocation tests and nasal cytology, as diagnostic battery, are used for the diVer- ential diagnosis of the patients with chronic rhinitis symp- toms. Evaluation of nasal epithelial samples is a part of clinical allergy practice. Mucosal inXammation characteris- tics of allergic rhinitis are associated with selective recruit- ment of eosinophils and basophils in the nasal mucous membrane [1]. Although nasal cytology has not gained common application in routine clinical practice, English lit- erature is replete with the statements about nasal cytology techniques, comparisons, and suggestions. But all these attempts failed to reach a consensus regarding a standard- ized method with high sensitivity and speciWcity. Sensitivity and speciWcity results of the nasal cytology methods diVer in the medical literature. These are primarily due to the fact that the sampling technique, counting M. C. Miman · O. Uzun · O. Ozturan · M. Akarcay Otorhinolaryngology Department, Inonu University, Malatya, Turkey I. Gurses Pathology Department, Inonu University, Malatya, Turkey I. Kuku Internal Medicine Department, Inonu University, Malatya, Turkey M. Akarcay (&) Turgut Ozal Medical Center, ENT Department, Inonu University, 44300 Malatya, Turkey e-mail: makarcay@inonu.edu.tr